Meet Phas3: The Startup Bringing Gold-Standard Cardiac Rehab Into the Home
After a significant cardiac event like a stent, bypass, or heart attack, only 20% of people who need cardiac rehab actually complete it. This startup from St. Louis is using a mobile platform and remote monitoring to triple those numbers.
The Challenge
Here’s a startling stat that rarely makes the news. According to the WHO, nearly a third of all deaths worldwide are due to cardiovascular diseases. In the United States alone, a person dies every 36 seconds from a heart condition of one kind or another. Of course, we put up a fight the best ways we know how. We have diets, exercise, and medications to keep the heart healthy. And then, when emergencies arise — as they do every day — people check in to hospitals for cardiac procedures like stents and bypasses.
These procedures are heroic wonders of modern medicine, saving lives by the thousands. But what happens when the heart attack patient leaves the hospital? What happens when the triple bypass patient has to get back to a full-time job? That moment, it turns out, is critical.
Heart procedures are major events and patients have to recover. The gold standard for this recovery period is called cardiac rehabilitation. Unlike physical therapy, cardiac rehab has to take place in the hospital setting, and it typically involves three sessions per week for twelve weeks. This regime is so beneficial to patients after undergoing a heart procedure that it’s a Class 1A recommendation, meaning that it’s basically irresponsible to not send a patient to get cardiac rehab.
Here’s the rub. Only 20% of patients who need cardiac rehabilitation get it. Why? The biggest reason is also the simplest. Patients are getting back to full-time jobs. They have families. Bills to pay. Who has the time and resources to come into the hospital three times a week for twelve weeks? The basic logistical hurdles are so high that many doctors have even stopped prescribing cardiac rehab. Why create more paperwork if only one out of five patients will comply?
For two young entrepreneurs in St. Louis, this gap in healthcare was a call to action. They knew we could do better, particularly now, in the COVID-induced golden age of remote healthcare.
The Origin Story
Lucas Rydberg was just a kid when he fell in love with medicine. He remembers going to work with his dad, who was a doctor on the White Mountain Apache Reservation in Arizona. In this remote, poverty-stricken setting he came face to face with issues of healthcare access. He saw firsthand that the level of care one receives is strongly dependent on where one happens to live. But he also noticed something else.
“I always thought it was interesting that when my dad’s patients showed up, they always had smartphones,” says Rydberg. “It just made sense to use those ubiquitous tools, even among poorer populations, to improve access to healthcare.”
A seed was planted in his mind, and when Lucas later moved to St. Louis to study biomedical engineering, the old thoughts traveled with him. While he was a student, he pitched an idea to a professor about an iPhone-based medical device. As it happened, another student, Dan Ebeling, had pitched this professor the very same idea, so he made an introduction. The two combined their research and experimented with a new kind of iPhone-based EKG reader.
As it turned out, EKG reading was just the warm-up. Rydberg and Ebeling quickly learned from cardiologists that the greatest pain point in the market wasn’t a lack of remote EKG monitors. That was being pretty well handled by the likes of AliveCor. The gap, and the opportunity, was in engaging patients in their recovery process after they’d had a heart event. This revelation was the spark the two entrepreneurs needed to set a course and establish the startup Phas3. Together they’d develop a telemedicine platform that would allow cardiologists to conduct cardiac rehab remotely, in a way that would help patients recover while also boosting revenue at struggling rehab facilities.
Under the Hood
As with many of the best ideas, the Phas3 product is pretty straightforward. It’s a mobile-first, remote care version of cardiac rehabilitation that allows patients to recover from home, while still allowing clinicians to bill and earn revenue.
Here’s how it works. When a patient is discharged from the hospital after a cardiac event like a heart attack or stent placement, they’re given the opportunity to enroll in a home-based cardiac rehab program rather than coming into the hospital three days a week for 12 weeks. While the patient could theoretically complete the entire program remotely, Phas3 recommends a few face-to-face check-ins with a physician over the course of three months.
It starts with an in-person intake session that allows physicians to meet the patient and build an appropriate care plan. They can also use that session to train the patient on using the app and the included connected devices — a Bluetooth heart rate monitor, blood pressure monitor, and weight scale.
From that point, clinicians can assign specific care plans through the Phas3 app and patients can work through guided exercises and activities each day. It’s clinician-driven and personalized to each patient. For example, they might ask their patient to walk at a moderate pace for 30 minutes and then track their heart rate. They might prescribe a gym session or some simple chair aerobics. Clinicians can also use the platform simply to teach, pushing targeted education to the patient based on their condition and their personal health metrics.
Why we’re proud to invest
Phas3 was born out of a bold health moonshot vision — to bring access to high-quality care to those who need it most, regardless of their location or economics. For Rydberg, it’s a personal mission that harkens back to a kind of servant-care he learned from his father. That’s the kind of drive necessary to disrupt an industry as entrenched as cardiology.
We’re also bullish on Phas3 because this market is so ripe for obvious change. Even though it’s a Class 1A recommendation — the gold standard — 80% of patients coming home after a cardiac event are doing absolutely zero cardiac rehab. The American Heart Association and the American College of Cardiology have each said that remote cardiac rehab programs can be safe and effective when done from home. That’s low-hanging fruit. Even early attempts at remote cardiac rehab can have an outsized positive impact.
Speaking of impact, the first implementation of Phas3 was in a clinical feasibility study in St. Louis. They showed a 66% increase in cardiac rehab enrollment and a three-fold increase in completion. Now, Phas3 is signing on provider groups ranging from smaller critical access hospitals to multi-facility hospital groups.
Finally, the best solutions address pain points for patients and providers alike. Phas3’s benefits to patients are obvious — increased access to high-quality rehab tools means better recovery outcomes. But the startup also built its offering around known, available CPT codes. That means that when a facility deploys Phas3, they immediately start building a new revenue line. That’s music to the ears of struggling healthcare facilities — facilities that need to stay in the black in order to keep serving patients.
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